Carmona's path to becoming the nation's top doctor was a dubious one. The son of a poor Puerto Rican immigrant, he dropped out of high school and languished on the streets in New York's Spanish Harlem getting in scrapes with the law.
He eventually enlisted in the army where he became a decorated soldier and started his career in medicine. During his address to the public health school graduates, Carmona frequently referred to lessons in his own life as what drives his agenda. A strong voice for anti-smoking efforts and control over rising rates of obesity, Carmona said merely treating diseases is not enough.
"Prevention is the only answer," he said. "Anybody else is fooling you. All the debates today about who pays. We all pay. You can shift the dollar from the federal to the state to the local governments. It doesn't make a difference. The burden is still there. And the disease burden will continue to mount until we--all of you who have connected the dots and are sitting here today--get out there and change that world."
One of the best currencies we have...to achieve peace and stability in an unstable world, is health diplomacy.U.S. Surgeon General Richard Carmona
But Carmona also warned the enthusiasm that might inspire a young college graduate to try and change the world also needs to measured. Carmona admitted that being surgeon general is more difficult than he thought it would be. He said anyone who takes the position seriously sleeps fitfully. Carmona said even the noble agenda of promoting health is subject to a difficult, partisan and combative environment of the nation's capitol.
"I've had to temper my metrics because I recognize that the progress we make in public health and global health is incremental," he said. "It's very rarely that sweeping legislation that changes the geography."
Carmona urged this year's 170 graduates of the School of Public Health to seek out ways to convey the message of health to the public--not just Americans but for people around the world. Caring for people's health is a way to balance out what Carmona called asymmetries in ideologies and theologies that cause conflicts.
"As those asymmetries grow, others around the world see us differently," he said. "I would submit to you that one of the best currencies we have not only to change health status globally but to achieve peace and stability in an unstable world, is health diplomacy."
Belying his colorful past, Carmona has kept a low profile on politically combustible topics such as abortion, stem cell research and birth control. Before his appointment by President Bush four years ago, he was a long-time political independent.
Carmona is forever tied to two storied accounts from his life before becoming surgeon general. In one, he rappelled from a hovering helicopter to treat a stranded survivor of a MedEvac helicopter crash. In another, he happened on a tense hostage situation and shot and killed a suspect who police say had already killed a family member. At the time Carmona was a surgeon and a sheriff's deputy for the Pima County SWAT team in Arizona.
John Finnegan, Dean of the U of M's School of Public Health said Carmona himself would make a good president. Finnegan said bringing him here for graduation is a coup for the school.
"We see our mission not only as a state one, but a national one and a global one," Finnegan said. "So having somebody here of his leadership caliber validates what we're doing in public health."
Last year's Public Health graduation speaker was Tommy Thompson, former Wisconsin Governor and President Bush's pick for Health and Human Services secretary.
The School of Public Health ceremony is one of more than a dozen graduations at the University of Minnesota and many more at institutions around the state as the academic year draws to a close.